Aircraft noise is a considerable source of stress among near-airport communities. Exposure has been associated with sleep disturbance, physiological responses and psychological reactions, with corresponding effects on blood pressure. However, the extent to which aircraft noise increases the risk of cardiovascular disease (CVD) has not been fully elucidated. Likewise, the role of CVD risk factors in mediating an association between noise and CVD has not been assessed. Additionally, exposure assessment that includes time-varying and spatially resolved noise exposures has not been systematically incorporated into previous epidemiological studies. This study proposes to evaluate the effects of aircraft noise exposure on CVD in the longitudinal Women's Health Initiative (WHI) study cohorts, in which over 160,000 women were recruited from 1993 to 1998 from 40 clinics in 24 states. To our knowledge, this represents the first study to apply aircraft noise exposure to a cohort study spanning a large number of airports. Specifically, this study will address previous study limitations and expand our understanding of the noise-health relationship by: (1) building historical noise models to assign exposure to residential addresses over time (1993-2012); (2) evaluating the relationship between aircraft noise exposure and CVD considering other noise sources and air pollution exposure; and (3) investigating the effect of exposure on CVD risk factors and roles of these risk factors as mediators of the noise-CVD relationship. Results from this study will allow us to estimate the proportion of CVD that could be reduced by decreasing exposure. As growth in aviation is anticipated and international, national and local interest in noise increases, the results of this timely study will inform strategies for reducing adverse health effects of aircraft noise and decisions regarding ambient noise levels that merit intervention.